Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Melissa Southard

Individual provider Occupational Therapy Assistant · NPI 1750778627

Melissa Southard is an Occupational Therapy Assistant in Canon City, Colorado. Licensed in Arizona and Colorado. Registered with an NPI since 2015.

Licensed in
AZ, CO
In the registry since
2015
Specialties on file
2

Practice location Address checks out

1401 Phay Ave
Canon City, CO 81212-2303
Phone: (719) 275-8656
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 0000928 (CO)
Occupational Therapy Assistant Taxonomy 224Z00000X · Licence 6144 (AZ)

Record details

NPI number1750778627
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 18, 2015
Last updated in NPPESJanuary 17, 2023
Certification dateJanuary 17, 2023
Mailing address25117 Sw Parkway Ave Ste D, Wilsonville, OR 97070-9697

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